Background A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students. Aim To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies. Research design Qualitative study with a content analysis according to Elo and Kinglas framework. Participants (...) and research context Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women. Methodology The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method. Ethical considerations Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form. Findings Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity. Conclusion All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas. (shrink)

Background: Students’ gaining and adopting basic professional values, improving their emotional intelligence skills during the process of nursing education plays a significant role on meeting the needs of healthy/patient individual and his or her family, and individualized care practices. Objectives: This (descriptive, correlational) research was carried out to evaluate the nursing values, emotional intelligence levels, and individualized care perceptions of senior nursing students and to determine the relationship between them. Research question: (1) What is the status of students to adopt (...) nursing values? (2) What is the level of students’ emotional intelligence? (3) What is the students’ individualized care perception? (4) Is there a relationship between students’ nursing values, levels of emotional intelligence, and individualized perceptions of care? Participants and research context: The research was carried out with 218 senior nursing students at the Faculty of Nursing, affiliated to a state university in Istanbul, who agreed to participate in the study, completing basic nursing education in May 2017. Ethical considerations: Ethical approval for this study was obtained from the Ethics Committee of Clinical Investigations of the Istanbul University Dentistry Faculty. Written permission was also obtained from the institution that research would be conducted. Before the data were collected, verbal permission was obtained by the investigator. Findings: It was observed that nursing values perceptions of students, emotional intelligence levels and individualized care perceptions were at a good level and there was a supportive relationship between them in the positive direction. It was determined that emotional intelligence skills of students, adoption of nursing values and individualized care perceptions increased in parallel with each other. Conclusion: In nursing education, nursing values peculiar to affective field, caring behaviors, and emotional intelligence skills that are guiding to maintain and direct these behaviors should be gained to students by supporting with correct learning methods and role models. (shrink)

Background: Moral philosophical positions and professional values have been shown to influence nurses’ practice behaviours. Understanding nursing students’ professional values and ethical ideologies, therefore, is important as they may help inform evidence-informed curriculum decisions and education strategies to develop students’ professional reflective competencies. However, there is a dearth in current empirical data on Canadian nursing students’ perceptions of professional values and ethical positions. Objectives: This study’s purpose was to examine undergraduate nursing student’s perceptions of professional values and ethical ideology and (...) explore relationships in data and selected participant demographic variables. Research design, participants and context: A descriptive cross-sectional research design was conducted with a convenience sample of undergraduate nursing students recruited from a university in Canada. An online encrypted survey consisting of two validated instruments was administered to participants who met study eligibility criteria. Descriptive and inferential statistics were employed to analyse the data and classify nursing students’ ethical ideologies into four categories based on mean scores for idealism and relativism. Ethical considerations: This study received ethical approval from the institutional Behavioural Research Ethics Board and was executed in-line with ethical principles for research involving humans. Findings: Nursing students scored high on professional values and ethical idealism and differed significantly on a measure of ethical relativism in terms of age and year of study. Professional values were significantly associated with ethical idealism. Based on mean scores for idealism and relativism, most nursing students in the study were classified as situationists. Discussion and conclusion: Findings suggest that faculty pay attention to influences of moral philosophical positions in facilitating nursing students’ professional values development. Implications for future research and curriculum are highlighted to strengthen nursing students’ professional values. (shrink)

Background and aim: Professional values are abstract and general behavioral principles that provide basic standards to judge aims and actions, and these principles are formed by strong emotional loyalty of members of the profession. Research was conducted to compare the career choice and professional values of nursing students at two universities in the upper Midwest of the United States and in the middle of Turkey. Materials and Methods: A descriptive and comparative design was used. The participants of the study were (...) comprised nursing students from a university in the upper Midwest of United States and a university in the middle of Turkey. The sample consisted of 728 students in all grades. Data were collected by a questionnaire, The Nurses Professional Values Scale–Revised and Vocational Choices in Entering Nursing Scale. Number, percentage distribution, mean, standard deviation, t test, and one-way variance analysis were used in the analysis of data. Ethical considerations: Ethical approval was obtained from the Ethics Commission. Informed consent was received from the students. Results: The students’ mean age for American students was 24.3 ± 5.6 years, while the mean age for Turkish students was 19.8 ± 1.7 years. Mean score of American students on The Vocational Congruency (a subgroup of the Vocational Choices in Entering Nursing Scale) was 38.5 ± 5.9 and Turkish students was 29.6 ± 8.9 (p < 0.05). Mean score of American students on The Nurses Professional Values Scale–Revised was 109.2 ± 12.3 and that of Turkish students was 101.6 ± 17.0. Conclusion: This study concluded that the majority of nursing students had high professional values, and when students’ scores were compared, American students had higher professional values, and in career choice, they considered primarily fitness of the profession to themselves and their goals, while Turkish students primarily thought of their living conditions. (shrink)

Background: Ethics, being a fundamental component of nursing practice, must be integrated in the nursing education curriculum. Even though different bodies are promoting ethics and nursing researchers have already carried out work as regards this concept, it still remains difficult to clearly identify the components of this competence. Objective: This integrative review intends to clarify this point in addition to better defining ethical competence in the context of nursing practice. Method: An integrative review was carried out, for the 2009–2014 period, (...) in the CINAHL, MEDLINE, and EMBASE databases and in the journal Nursing Ethics. The keywords nursing ethics or ethical competence were used in order to make sure to widely encompass the concept of “ethical competence” in the case of a university curriculum in nursing. In the end, 89 articles were selected. Ethical consideration: We have respected the ethical requirements required regarding the sources and authorship. There is no conflict of interest in this literature review. Results: Ethical sensitivity, Ethical knowledge, Ethical reflection, Ethical decision-making, Ethical action, and Ethical behavior are the most frequently used terms with regard to ethical competence in nursing. They were then defined so as to better ascertain the possible components of ethical competence in nursing. Conclusion: Even though ethical competence represents a sine qua non competence in nursing practice, no consensus can be found in literature with respect to its definition. The identification of its components and their relationships resulting from this integrative review adds to the clarification of its definition. It paves the way for other studies that will contribute to a better understanding of its development, especially among nursing students and practicing nurses, as well as the factors that may exert an influence. More adapted education strategies can thus be put forward to support its development. (shrink)

Background:Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students.Aim/objective:The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students.Research design:The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of undergraduate nursing students.Participants and research (...) context:A total of 293 baccalaureate Filipino nursing students who have been exposed to various clinical areas participated in the study.Ethical considerations:Institutional review board approval was sought prior to the conduct of the study. Self-determination was assured and anonymity and confidentiality were guaranteed to all participants.Findings:Results indicate that a majority of the nursing students in the clinical areas encounter morally distressing situations that compromise quality patient care. However, despite the fact that they want to do what is in the best interest of their patients, their perception of being the inexperienced among the healthcare team drives the majority of them to ignore morally distressing situations to avoid conflict and confrontation. Another interesting finding is that 79.20% of the respondents hardly consider quitting the nursing profession even if they frequently encounter morally distressing situations. Analysis also shows associations between moral distress intensity and frequency ( r = 0.13, p < 0.05) and moral distress intensity and moral sensitivity ( r = 0.25, p < 0.05). The dimensions of moral courage are also related to both moral distress and moral sensitivity.Conclusion:Results of the study imply that moral distress is a reality among all healthcare professionals including nursing students and requires more consideration by nurse educators. (shrink)

Background: Growing evidence suggests that collaborative practice improves healthcare outcomes, but the precursors to collaborative behavior between nurses and physicians have not been fully explored. Research question: The purpose of this descriptive correlational study was to describe the professional values held by nurses and their attitudes toward physician–nurse collaboration and to explore the relationships between nurses’ characteristics (e.g. education, type of work) and professional values and their attitudes toward nurse–physician collaboration. Research design: This descriptive correlational study examines the relationship between (...) nurses’ professional values (Nurses Professional Values Scale–Revised) and their attitudes toward nurse–physician collaboration (Jefferson Scale of Attitudes toward Physician–Nurse Collaboration). Ethical considerations: Permission to conduct the study was received from the hospital, and the Institutional Review Boards of the healthcare system and the participating university. Participants/context: A convenience sample of 231 registered nurses from a tertiary hospital in the United States was surveyed. Findings: A significant positive relationship was found between nurses’ professional values and better attitudes toward collaboration with physicians ( r =.26, p <.01). Attitude toward collaboration with physicians was also positively associated with master’s or higher levels of education ( F(3, 224) = 4.379, p =.005). Discussion: The results of this study can be helpful to nurse administrators who are responsible for developing highly collaborative healthcare teams and for nurse educators who are focused on developing professional values in future nurses. (shrink)

Background: In order to prove their commitment to the nursing profession, nurses need to base their professional activities on certain acknowledged values. Although a large number of studies have addressed professional values in nursing, only a few studies are available on the identification and comparison of nurses’, nursing students’, and nursing instructors’ understanding of such values. Objective: The study aims to compare nurses’, nursing students’, and nursing instructors’ perception of nursing professional values. Research design: In this descriptive-comparative study, data were (...) collected using Weis and Schank’s Nurses’ Professional Values Scale–Revised. The data were analyzed using the SPSS statistical software (v 22). Participants and research context: A total of 299 nurses, 341 nursing students, and 100 nursing instructors from multisite, 20 different wards from 3 university hospitals and associated nursing schools located in the cities of Shiraz, Fasa, and Jahrom in Fars province, participated in 2016. Ethical considerations: The Institutional Review Board of the researchers’ primary university has verified that the study complies with research ethics. Findings: The total mean scores of the nurses’, nursing students’, and nursing instructors’ perception were found to be 4.23 (0.44), 3.92 (0.50), and 4.34 (0.35), respectively, in the domain of justice—this domain was the subjects’ top priority—and 3.40 (0.56), 3.29 (0.49), and 3.55 (0.36), respectively, in the domain of activism—this domain was attached the least importance by the subjects. There were significant differences across the three groups’ perception in all of the dimensions of professional values ( p < 0.001). Discussion: The three study groups’ overall mean scores fall within the range of relatively important or important. Several studies show the same results, but there are still controversies in this regard. Conclusion: There is need for plans to increase nurses’ awareness of certain professional duties and improve their professional performance in all areas alongside their care duties. (shrink)

Background: Pain management is a fundamental human right for everyone who experiences it. The management of pain is an ethical obligation for all health professionals. Professional values have an important place in appropriate clinical decision-making. Research aim: This study was conducted to determine the relationship between nurses' ethical attitudes in pain management and their compliance with professional values. Research design: The study was conducted as a descriptive and correlational research. The study data were collected by online survey method using the (...) Introductory Characteristics Form, Ethical Attitude Scale for Pain Management in Nursing, and Nurses Professional Values Scale – Revised. Participants and research context: The population of the study consisted of nurses working in tertiary treatment centers in a country. A total of 388 nurses participated in the study. Ethical considerations: Ethical approval was obtained from the University Ethics Committee. Consent was obtained from the nurses. Results: The mean total score of the Ethical Attitude Scale for Pain Management in Nursing was 98.96 ± 9.37, and the mean total score of the Nurses Professional Values Scale was 101.51 ± 15.20. The scores of the Ethical Attitude Scale for Pain Management in Nursing were positively and moderately correlated with the total scores of the Professional Values Scale. Compliance with professional values explained 41% of the total variance of ethical attitude for pain management. Conclusions: In this study, it was found that nurses' ethical attitudes for pain management and compliance with professional values were at a high level, compliance with professional values was associated with ethical attitudes for pain management, and ethical attitudes for pain management decreased with increasing working years. A nurse with high ethical sensitivity and compliance with professional values can easily recognize ethical problems, effectively manage the ethical decision-making process, and provide appropriate patient care. (shrink)

Aim: This study was carried out in order to determine professional self-concept and professional values in the students, who were studying in the final year of the nursing department in schools providing undergraduate education in the Inner Anatolia Region. Method: This cross-sectional study was conducted on a total of 619 senior students of nursing departments in the Inner Anatolia Region. Data were collected using a Student Information Form, Professional Self-Concept Scale for the Student Nurses, and The Nurses’ Professional Values Scale. (...) Descriptive statistics, the Shapiro–Wilk test, the t-test, analysis of variance, and the Bonferroni tests were used for data analysis. Ethical Considerations: A written consent was obtained from Ethics Board of Erciyes University Faculty of Medicine and from nursing schools participating in the study. Prior to data collection, students were informed about the purpose of the study and gave written and verbal consents. Participation in the study was on voluntary basis. Findings: In the study, students’ total and sub-dimension scores from the Professional Self-Concept Scale for the Student Nurses and total scores from the Nurses’ Professional Values Scale were moderately high. It was detected that women received higher scores than men from the sub-dimension of professional attributes; the students who had positive perception of the nursing image and voluntarily selected their department received high scores from professional satisfaction, professional competence, and professional attributes sub-dimensions of the Professional Self-Concept Scale for the Student Nurses ( p < 0.001). Implication: In order to improve students’ perceptions of professional self-concept and professional values, it is thought that students’ awareness should be increased on these topics. (shrink)

Background: Values are ideals and beliefs that individuals and groups uphold and lie at the core of the diverse world of human behaviour and are expressed in every human decision and action, both consciously and unconsciously. They represent basic beliefs of what is right, good or desirable and motivate both personal and professional behaviour. In the context of nursing profession, values are essential in order to maintain high standards of the nursing care. Objectives: This study was planned to examine changes (...) in nursing students’ personal and professional values between entering and graduating from an undergraduate nursing programme. Ethical considerations: Measures to protect participants included obtaining Deaconship of Nursing Faculty approval, obtaining signed informed consent and maintaining confidentiality. Methods: This study was designed as longitudinal quality. The research population included 143 students registered at a first grade of a nursing faculty for the 2009–2010 academic year. Data were collected with a Questionnaire Form, the Value Preferences Scale, the Professional Values Precedence Scale and the Nursing Professional Values Scale. Findings: According to the results, social values have statistical differences in 4-year nursing education. Nursing students in second class have higher score in terms of social values than those in third class. Also, majority of students ranked human dignity as first and justice as second and third from first to fourth classes, and they have very high scores on Nursing Professional Values Scale and its subscales and stated that all items of Nursing Professional Values Scale are very important. Conclusion: As a result, nursing education has vital role in acquiring and maintaining professional values. (shrink)

Background: Development of professional nursing values is critical within registered nurse–to–bachelor of science in nursing programs to prepare nurses for increasingly complex and diverse work environments. The results of previous studies have been inconsistent, with few studies focusing on online registered nurse–to–bachelor of science in nursing programs. In addition, little is known regarding the effectiveness of the educational methods used to support advancement of professional values and ethical practice. Objective: The object of this study was to gain an understanding of (...) nursing students’ attitudes and beliefs about professional values at entry and exit of an online registered nurse–to–bachelor of science in nursing program that includes a standalone ethics course and integrates American Nurses Association Code of Ethics provisions throughout the curriculum. Research design: For this one-group pretest–posttest, quasi-experimental design, longitudinal matched-pair data were gathered at program entry and exit using the Nurses Professional Values Scale–Revised. Participants and research context: In all, 119 students of an online registered nurse–to–bachelor of science in nursing program at a Midwest public university who completed entry and exit surveys between spring 2015 and spring 2018 were included in this study. Ethical considerations: This study was reviewed and determined to be exempt by the university’s institutional review board. Findings: The results showed a significant increase in total posttest scores when considering all participants. However, students who took the ethics course after the pretest demonstrated a significant increase in posttest scores, while students who took the ethics course prior to the pretest demonstrated a small increase that was not statistically significant. Significant increases were also found in the professionalism, activism, and trust factors. Discussion: This study supports previous study findings where students scored higher on caring and lower on activism and professionalism factors. The largest gains were made after completing the ethics course. Conclusion: The results suggest that requiring a standalone ethics course in the registered nurse–to–bachelor of science in nursing curriculum had a positive impact on self-reported professional values. (shrink)

Background: It is obvious from literature within the nursing discipline that nursing is related to moral or moral–philosophical related ideas which are other-oriented. The socio-cultural process of change in modern society implies that more self-oriented ideas have been found to be significant. Aim: The overall aim of this article is to highlight self-oriented moral or moral–philosophical related ideas as an important part of the nursing discipline. This is achieved by (a) exploring self-realization as a significant self-oriented moral or moral–philosophical related (...) idea based on a philosophical anthropological perspective, (b) demonstrating how moral or moral–philosophical related ideas are expressed by nurses, (c) discussing the relevance of self-realization for the nursing discipline, and (d) pointing out possible consequences for the future development of the discipline of nursing. Research design: This theoretical study draws empirical examples from interviews. Participants and research context: Data consisted of interviews with 13 nurses with varying work experience within the primary and secondary somatic and psychiatric health service, from inside as well as outside institutions. Ethical considerations: The empirical study was approved by the Norwegian Social Science Data Services. Information was given and consent was obtained from the study participants. Findings: Findings are presented in two themes: (a) other-oriented ideas and (b) self-oriented ideas. More concretely, the findings show that nurses hope to make life as good as possible for the patient and they have a wish to improve themselves as human beings, to become better persons. Discussion: The relevance of self-realization for the nursing discipline is discussed along two lines, first, by connecting nurses’ self-understanding to a horizon of identity and second, by considering what self-realization could offer. Conclusion: It is of ultimate concern for the nursing discipline to highlight self-realization connected to the positive view of freedom understood as an exercise-concept. Further identifying and articulating the contribution of self-realization to nurses and nursing practice is of particular importance. (shrink)